SAN FRANCISCO — Moderate consumption of alcohol can be part of a healthy lifestyle to prevent cardiac disease, but not if you drink too fast, Dr. Mary O. Gray said at a meeting sponsored by the California chapter of the American College of Cardiology.
The cardioprotective benefits of alcohol appear to be limited to one drink per day for women or two drinks per day for men (with a “drink” consisting of one glass of wine, one shot of liquor, or one bottle or can of beer). Beyond that, alcohol is cardiotoxic, said Dr. Gray of San Francisco General Hospital.
Binge drinking—defined as consuming three or more drinks in 1 or 2 hours—doubled the risk of death from any cause in a recent study of patients treated for acute MI (Circulation 2005;112:3839–45). Investigators interviewed 2,000 patients a median of 4 days after a confirmed MI and found that regular consumption of alcohol reduced their risk of death, but binge drinking blocked or attenuated this benefit.
The negative effects of binge drinking applied regardless of whether a person was a light or heavy drinker overall. The study also asked about other factors that might affect cardiovascular risk, such as vigorous activity or vigorous sexual activity, but found no correlation with mortality, Dr. Grey said at the meeting, also sponsored by the University of California, San Francisco.
Heavy drinking for a long time can cause alcoholic cardiomyopathy, a diagnosis made clinically through history and elimination of other etiologies. Heavy drinkers with hypertension or heart failure should be advised to stop drinking to preserve their hearts.
Data on very heavy drinkers suggest that those who develop heart failure may recover cardiovascular function if they stop drinking. Recovery is more likely if the patient is relatively young and has no other risk factors for cardiovascular disease. An older patient who also uses cocaine or has coronary disease or diabetes is much less likely to recover cardiac function with abstinence, she said.
Heavy drinkers often are malnourished, so treatment should include focus on a healthy diet with thiamine supplementation, Dr. Gray advised. The investigators also plan to study the interplay between cigarette smoke and alcohol consumption.